Key result
Rivaroxaban shows no clinical benefit over warfarin but saves ~$13,261 annually per patient.
Why the study?
The cost-effectiveness of rivaroxaban compared to warfarin in reducing hospitalization and mortality among nonvalvular AF patients in Saudi Arabia was largely unknown.
Does rivaroxaban reduce the composite of stroke, MI, ED visits, hospitalization, and death, and lower costs in nonvalvular AF patients compared to warfarin?
Cohort (n=226)
No
Does rivaroxaban reduce the composite of stroke, MI, ED visits, hospitalization, and death, and lower costs in nonvalvular AF patients compared to warfarin?
In a Saudi Arabian cohort of nonvalvular AF patients, rivaroxaban was associated with non-inferior clinical effectiveness and significant cost savings compared to warfarin.
Answers are grounded in this paper and cite their sources.
May support cost considerations in Saudi nonvalvular AF; leaves open randomized confirmation of effectiveness versus warfarin.
Background: Rivaroxaban is a novel oral anticoagulant (NOAC) that is commonly used for stroke prevention among patients with atrial fibrillation (AF). However, its cost effectiveness in reducing the risk of hospitalization and mortality in comparison to warfarin among nonvalvular AF patients in Saudi Arabia is largely unknown. Methods: This was a single-center retrospective chart review of adult patients (≥18 years) with nonvalvular AF who were treated with warfarin or rivaroxaban for at least 12 months. Patients with mitral valve stenosis were excluded from the study. Multiple logistic regression was conducted to examine the risk of hospitalization and mortality as a composite outcome, and all annual healthcare costs were captured. Inverse probability treatment weighting with bootstrapping was conducted to determine the mean costs and effectiveness rates. Rivaroxaban resulted in a mean annual cost saving of $13,260.79 with an 87.65 % confidence level that it would be more effective than warfarin with a mean difference in effectiveness rate of 0.168 % (95 % CI [-5.210-18.36]). Conclusion: Rivaroxaban was associated with lower direct medical costs and non-inferior effectiveness among nonvalvular AF patients in comparison to warfarin.
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AlRuthia et al. (2022) conducted a cohort in Nonvalvular atrial fibrillation (n=226). Rivaroxaban vs. Warfarin was evaluated on Composite outcome of ED visit, hospitalization, stroke, myocardial infarction, and death (OR 0.785, 95% CI 0.427-1.446, p=0.443). Rivaroxaban did not significantly reduce the odds of the composite clinical outcome compared to warfarin (OR 0.785) but resulted in a mean annual cost saving of $13,260.79 per patient.
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